http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
국한성 결절성 근염(Localized nodular myositis) 2례
서기현 ( Gi Hyeon Seo ),김지은 ( Jee Eun Kim ),김진석 ( Jin Seok Kim ),고은미 ( Eun Mi Koh ),이종헌 ( Chong H. Rhee ),안중모 ( Joong Mo Ahn ),서연림 ( Yeon Lim Suh ) 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1
Localized nodular myositis is an uncommon benign inflammatory myopathy of unkonwn cause affecting skeletal muscle and, presenting as a localized painful swelling within the soft tissue of an extremity. Histological examination reveals lymphocytic infiltration, scattered muscle fiber necrosis and regeneration, and interstitial fibrosis. MRI finding is an enhancement with increased signal intensity around the lesion. We report two cases of localized nodular myositis presenting as pseudothrobothrombophlebitis. We believe this is the first case report of localized nodular myositis in Korea.
Adult onset Still`s disease 환자에서 질환의 활동지표로서의 혈중 Ferritin의 역할
서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),고은미 ( Eun Mi Koh ) 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1
Objective: Adult onset Still`s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. Methods: Seven patients who were diagnosed as adult onset Still`s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. Results: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml; normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively. There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. Conclusions: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
통풍환자에서 Allopurinol 투여 후 나타난 간기능이상
서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),고광철 ( Kwang Cheol Koh ),고은미 ( Eun Mi Koh ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
Objective: To investigate the incidence and clinical course of the patients who had liver function test abnormalities during treatment with allopurinol. Methods: 62 patients who were diagnosed as gout and were treated with allopurinol at Samsung Medical Center between 1995 and 1997 were reviewed. In these patients, liver function tests were checked before and during treatment for 6 months. The term of `abnormalities of liver function test` was defined when there was an increase of more than 1.5 times of upper limit of normal values or baseline values in anyone of bilirubin, asparate transaminase, alanine transaminase and alkaline phosphatase. Results: During treatment with allopurinol, 25 patients(40.2%) showed abnormalities of liver function test. 10(25.0%) of 40 patients who had normal liver function tests before treatment showed abnormalities of liver function tests during treatment, while 15(68.2%) of 22 patients who had abnormal liver function tests before treatment showed abnormalities during treatment. In 12 of the 25 patients who showed abnormalities of liver function tests during treatment with allopurinol, allopurinol was stopped and all patients showed improvement of liver function tests. In remaining 13 patients, 10 patients were improved and other 2 patients showed only mild abnormalities of liver function tests despite of continuing allopurinol and 1 patient was lost during follow-up. Conclusions: Abnormalities of liver function tests were common during treatment with allopurinol. Most patiensts who had mild abnormalities of liver functions tests during treatment with allopurinol were improved regardless of continuing allopurinol.
미만성 폐포출혈을 동반한 전신성 홍반성 루푸스 환자에서 Plasmapheresis를 이용한 치험
고재현 ( Jay Hyun Koh ),송서영 ( Seo Young Song ),이창근 ( Chang Keun Lee ),서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),고은미 ( Eun Mi Koh ),송재훈 ( Jae Hoon Song ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.2
Pulmonary alveolar hemorrhage (PAH) is a rare and often fatal presenting feature of systemic lupus erythematosus (SLE) and enters the differential diagnosis of diffuse lung disease in patients with SLE. Reported mortality rates are extremely high, between 70 and 90 percents. Because death frequently occurs within the first several days of the hemorrhage, the diagnosis needs to be established promptly and treatment should be initiated immediately. Treatment of alveolar hemorrhage has included various combinations of corticosteroids, cytotoxic agents, and plasmapheresis, but survival rates have been extremely low despite aggressive therapy. We experienced a case of diffuse alveolar hemorrhage in a 29 year-old SLE male patient. PAH was diagnosed by hemoptysis, anemia, infiltration on chest X-ray and hemosiderin-laden macrophages in bronchoalveolar lavage. After high dose intravenous steroid, cyclophosphamide intravenous therapy and plasmapheresis, the condition of patient was markedly improved. He was discharged and received monthly intravenous pulse cyclophosphamide. He has done well since, showing no further pulmonary hemorrhage with steroid tapering.
전신성 괴사성 혈관염에서 다발성 단신경염의 임상적 고찰
김진석 ( Jin Seok Kim ),차훈석 ( Hoon Suk Cha ),서기현 ( Gi Hyun Seo ),안홍준 ( Hong Joon Ahn ),이창근 ( Chang Keun Lee ),고재현 ( Jae Hyun Koh ),김현숙 ( Hyeon Sook Kim ),최동철 ( Dong Chull Choi ),고은미 ( Eun Mi Koh ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
Background: The vasculitides are heterogeneous clinical syndromes characterized by inflammation of blood vessels. There are no pathognomonic symptoms. Mononeuritis multiplex is an acute or subacute asymmetric sensory motor syndrome involving discrete peripheral nerves and is known to occur in many illnesses including certain types of systemic vasculitis. Our purpose was to evaluate the clinical manifestations and significance of mononeuritis multiplex in systemic necrotizing vasculitis. Patients & Methods: Eight patients who were diagnosed as systemic necrotizing vasculitis at Samsung Medical Center between 1995 and 1997 were reviewed. Vasculitis was diagnosed by ACR criteria for each vasculitis and microscopic polyangiitis was diagnosed by the Chapel Hill Consensus Conference on the nomenclature of systemic vasculitis. Three were diagnosed as Churg-Strauss syndrome, 3 as polyarteritis nodosa, and 2 as microscopic polyangiitis. In most cases, vasculitis was confirmed by a biopsy specimen showing infiltration of granulocytes, lymphocytes, and/or plasma cell into vessel walls. Occasionally, polyarteritis nodosa was confirmed by mesenteric or renal arteriography which showed microaneurysms. EMG/NCV was performed in seven patients who had neuropathy. Results: Seven of the eight patients presented with mononeuritis multiplex and one had no neuropathy. Four patients presented with neuropathy as the first symptom, and three developed neuropathy within 3 weeks after the onset of vasculitis symptoms. The peroneal nerve and sural nerve were involved in all seven patients. The median nerve, ulnar nerve and posterior tibial nerve were involved in four, two and six patients, respectively. All seven patients had lower extremity involvement. Two showed only lower extremity involvement and five had both lower and upper extremity involvement. Isolated upper extremity involvement was not seen. All patients with mononeuritis multiplex were improved by treatment with cyclophosphamide and steroid therapy. Conclusion: Mononeurtis multiplex is a common manifestation of vasculitis and occurs early in the course of systemic vasculitis. Prognosis of mononeuritis multiplex is excellent, although it may take up to one year to recover.
초기 류마티스 관절염에서 적혈구 침강속도, 혈청 C-반응성 단백과 방사선학적 진행의 상관관계
고재현 ( Jay Hyun Koh ),김재형 ( Jae Hyung Kim ),이창근 ( Chang Keun Lee ),전찬홍 ( Chan Hong Jeon ),서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),안중모 ( Joong Mo Ahn ),고은미 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.4
Objective: To investigate the clinical usefulness of serial measurement of erythrocyte sediment rate(ESR) and C-reactive protein(CRP) for monitoring the radiological progression in early rheumatoid arthritis(RA). Methods: Thirty one patients with RA according to the 1987 ACR criteria, with joint symptoms for less than one year, and who had not previously received disease modifying antirheumatic drugs(DMARDs) were assessed from Oct. 1994 to Aug. 1998 in retrospective study. Area under curve(AUC) of ESR and CRP were calculated in these patients. Joint damage in the hands was assessed by modified Sharp`s method. Results: Male to female ratio was 1: 3.4. Median age of this group was 45.8±13.2 years. Patients who had positive rheumatoid factor were 82%. Mean duration until first visit was 271.9±145.8 days. At the first clinic visit, mean ESR and CRP were 50mm/hr and 2.0mg/dL. Mean erosions and joint space narrowing score by modified Sharp`s method were 55.2 and 12.4, respectively. Correlation analysis showed that ESR AUC and CRP AUC were significantly associated with radiologic progression. Conclusions: Elevated over-time ESR and CRP provide a convenient short term correlation with radiologic outcome(i. e. erosions). Elevated over-time ESR and CRP can be used as a guide for therapy.
이창근,김재준,고은미,김진석,서기현,차훈석,고재현,안홍준 대한내과학회 1999 대한내과학회지 Vol.57 No.1
Rheumatoid vasculitis is a necrotizing arteritis of unknown causes that affect a subset of patients with rheumatoid arthritis. Vasculitis associated with rheumatoid arthritis was first recognized in 1898. It was described frequently in the 1940s through 1960s but is now rarely diagnosed. Typical clinical features include constitutional symptoms, mononeuritis multiplex, skin infarction, ulceration, peripheral gangrene and visceral infarction. Gastrointestinal involvement occurs in 10 to 38% of cases of rheumatoid vasculitis and may include bowel infarction, ulceration, perforation, colitis, stricture, or bleeding. Ischemia of the intestine is the end result of interruption or reduction of its blood supply. However, the clinical manifestations of intestinal ischemia range from mild chronic symptoms to a catastrophic acute episode, depending on the vascular supply involved, the extent of the occlusion or ischemia, and the rapidity of the process. Physicians caring for patients with rheumatoid arthritis should be aware that intestinal ischemia or infarction may occur without overt clinical evidence of systemic rheumatoid vasculitis. Herein we describe a case of rheumatoid vasculitis manifesting as ischemic colitis which was intractable to medical therapy and led to subtotal colectomy.